June 1, 2015 «PH_NAME» «GRP_ADDR_LINE_1» «GRP_ADDR_LINE_2» «GRP_SUITE» «GRP_CITY», «GRP_STATE» «GRP_ZIP» Policyholder ID: «PHID»
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1 Health Net of California, Inc. Health Net Life Insurance Company PO Box 9103 Van Nuys, CA A. Ortiz: CA «PH_NAME» «GRP_ADDR_LINE_1» «GRP_ADDR_LINE_2» «GRP_SUITE» «GRP_CITY», «GRP_STATE» «GRP_ZIP» June 1, 2015 Policyholder ID: «PHID» Upcoming change to your small business group coverage Dear «GRP_ADDR_LINE_1», Hello! Thank you for choosing health coverage from Health Net of California, Inc. and/or Health Net Life Insurance Company (Health Net). We re proud to support the health of your employees and your business. We ve made some changes to our Small Business Group (SBG) portfolio that we re telling you about now, so you can make your choices in advance of your renewal date. Plan closures Transitional Relief plans will be closed as of your renewal date. These are plans that groups were allowed to keep into 2015 even though they aren t compliant with all the Affordable Care Act (ACA) changes. WholeCare and Salud HMO y Más ACA-compliant plans that were in effect prior to 2015 will be closed as of your renewal date. We now offer refreshed versions of these popular plan types. Plan portfolio choices that work for your business Health Net has you covered with our 2015 SBG portfolio of ACA-compliant plans. (continued)
2 On your renewal date in 2015, you can choose from: Health Net of California, Inc. WholeCare HMO Platinum $10 WholeCare HMO Platinum $25 WholeCare HMO Platinum Standard Copay WholeCare HMO Gold $35 WholeCare HMO Gold $45 WholeCare HMO Gold Standard Copay Salud HMO y Más Platinum $10 Salud HMO y Más Platinum $20 Salud HMO y Más Platinum $25 Salud HMO y Más Gold $35 Salud HMO y Más Gold $45 Health Net Life Insurance Company Health Net Platinum 90 PPO Health Net Gold 80 PPO Health Net Silver 70 PPO Health Net Bronze 60 PPO Health Net Gold 80 EPO Alternate Health Net Silver 70 HSA EPO Alternate SmartCare HMO Platinum 10 SmartCare HMO Platinum 20 SmartCare HMO Platinum 30 SmartCare HMO Gold 40 SmartCare HMO Gold 50 PureCare HSP Silver Standard Coinsurance PureCare HSP Bronze Standard Coinsurance Mark your calendar to make your plan selection by September 1, We will send you a renewal package at least 60 days before your current plans expire. It will include detailed information about our plan offerings and corresponding rates. Included will be the plan(s) most similar to the one you have now. You ll be able to move to that plan automatically, or choose among our other options. You can work with your broker or Health Net directly to select a new plan(s). You and your employees will also have an opportunity to enroll for health coverage through the California Health Benefit Exchange (Covered California TM ), without medical underwriting, for a September 1, 2015, effective date. As an employer, you can enroll in any small employer plans offered through Covered California for a September 1, 2015, effective date. Employees can enroll, under a Special Enrollment Period, in any individual and family health plan offered through Covered California for a September 1, 2015, effective date. Generally, for applications received between the 1st and the 15th of the month, coverage will be effective the first day of the following month. For applications received between the 16th and month s end, coverage will be effective the first day of the second month following submission of application. (continued)
3 You will be able to obtain this coverage through the Covered California website at Additional information regarding health coverage choices through Covered California is included with this letter. Again, you don t have to take action now. You ll soon receive your renewal package from Health Net that will have all the information you need! The fine print Health Net of California, Inc. has Department of Managed Health Care regulatory approval to withdraw certain HMO plans from the market and to offer replacement benefit designs. This letter provides you with the required prior notice of discontinuance of your plan on your next renewal date. Health Net is required to send a letter to your employees about this coverage change. Included with this notice is a copy of the letter we ll be sending them. Also included is the notice required by the Centers for Medicare & Medicaid Services (CMS), which contains additional information about obtaining coverage through Covered California TM for Small Business (formerly the Small Business Health Options Program, or SHOP). Health Net Life Insurance Company has filed with the California Department of Insurance to withdraw Transitional Relief PPO plans from the market and to offer replacement benefit designs. Here for you and your employees We appreciate your business and thank you for making us your trusted health care partner. For more information about Health Net s Small Business Group plans, please call your broker or Health Net at , option 2. Sincerely, Scott St. Clair Chief Sales Officer, Western Region Individual & Small Business Group Health Net HMO and HSP plans are offered by Health Net of California, Inc. Health Net PPO and EPO insurance plans are underwritten by Health Net Life Insurance Company. Health Net of California, Inc. and Health Net Life Insurance Company are subsidiaries of Health Net, Inc. Health Net is a registered service mark of Health Net, Inc. Covered California is a registered trademark of the State of California. All rights reserved. LTR002204EW00 EMP_SEPT (5/15)
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5 Health Net of California, Inc. Health Net Life Insurance Company PO Box 9103 Van Nuys, CA A. Ortiz: CA Important: Your Group Health Coverage Will Not Be Available This Year. Dear «GRP_ADDR_LINE_1», We have decided not to offer your group s current health coverage again this year. The current coverage will end on September 1, This means you may need to choose a new plan for your group members to have health insurance coverage. This letter explains the options available to you. Options from Health Net of California, Inc. and Health Net Life Insurance Company You can choose any other small group coverage offered by Health Net of California, Inc. and/or Health Net Life Insurance Company (Health Net). Call , option 2, or visit to learn about plans available to you. What other options do I have? You may be able to choose a new health plan, or offer your employees a choice of plans, through different insurance companies, through the California Health Benefit Exchange (Covered California ). If you have fewer than 25 full-time-equivalent employees, you might qualify for a small business health care tax credit if you buy insurance through Covered California. You can choose to buy a new health plan outside Covered California directly from an insurance company or with the help of an agent or broker. But remember: If you re eligible for a small business health care tax credit, you usually can get that credit only if you buy a plan through Covered California. What else should I look at before deciding? Call or visit the plan s website to check which doctors, other health care providers, and prescription medications are covered by the plan. This is an important step when choosing a plan that meets the needs of your group members. When do I need to make a decision? You generally can buy coverage any time. If group members enroll by the 15th of the month, coverage can begin on the 1st of the following month. (continued)
6 We are notifying your employees Federal law requires that we notify all group members with this coverage that it is no longer being offered. Because we might not know about other coverage decisions you have made, we ll tell your employees to check with the plan sponsor or administrator about coverage options that might be available through your organization. Questions? Call Health Net at , option 2, Monday through Friday, from 9:00 a.m. to 5:00 p.m. Visit or call Covered California at to learn more about Covered California. Getting help in other languages Spanish (español): Para obtener asistencia en español, llame al Health Net at Chinese
7 Sample Employee Letter, page 1
8 Sample Employee Letter, page 2
October 3, 2014 «PH_NAME» «ADDRESS_1» «ADDRESS_2» «SUITE» «CITY», «STATE» «ZIP» Policyholder ID: «PHID»
Health Net of California, Inc. PO Box 9103 Van Nuys, CA 91409-9103 A. Ortiz: CA-900-03-20 www.healthnet.com «PH_NAME» «ADDRESS_1» «ADDRESS_2» «SUITE» «CITY», «STATE» «ZIP» October 3, 2014 Policyholder
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